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Thursday, 4 October 2012

How to get Authorization from OrthoNet for Spinal Surgery and Pain Management Programs for Humana?

Humana has delegated the precertification of spine surgery in any setting as well as pain management procedures (not including trigger point injections) in all settings to OrthoNet. These procedures and their CPT codes are listed on the applicable Humana Prior Authorization List which can be viewed at Humana’s website

We need to submit the Spinal Surgery and Pain Management Programs request form to OrthoNet and need to fill the below information. Its need to be fax #1-800-605-5345

Provider Information

Provider Name

Street Address

City

State

Zip

Telephone Number

Fax Number

Fax Date

Number of Pages faxed

NPI

Provider Tax Id number

Patient Information

First Name

Last Name

Humana Member ID Number

Date of Birth

Diagnosis code

Request Information

Request for Pain Region

Spinal Region

Has the patient had prior spinal surgery?

Is this the first epidural steroid or facet injection for this patient?